A review of alcohol consumption and mortality, bottoms up for me

The  Medical Journal of Australia has published a paper on alcohol consumption, cancer and heart disease. If you like a ‘grog’ as the Australians do, it makes grim reading. As reported on here by Yahoo “Forget safe drinking levels – any amount of alcohol could give you cancer.  Alcoholic drinks and ethanol are carcinogenic to humans and there’s no evidence there’s a safe consumption threshold to avoid cancer….” The misery continues when on alcohol and heart disease, “The previously reported role of alcohol in reducing heart disease risk in light-to- moderate drinkers appears to have been overestimated,” the council said. (1)

The results may be surprising to many as there is an abundance of evidence that drinking leads to a reduction in heart disease and even mortality.  There was a recent review in the British Medical Journal and covered by author and historian Chris Snowdon (2&3) suggests out of 31 studies 1 showed an increased risk, 1 the null hypothesis and 29 protection. As Chris rightly notes correlation is not causation but however alcohol may well thin the blood to stop platelet aggregation, giving a scientific explanation.  The other papers after (3) also confirm the protective nature of alcohol with the one I marked (4) being the most interesting.

Being a cohort, actually studying people over a number of years as opposed to case controlled, where people suffering from a disease are asked to recount their lifestyle or in some cases relations. The details are:

“Participants were 13,064 men and 11,459 women, aged between 20 to 98 years, from three Copenhagen studies. Information was obtained on alcohol intake and lifestyle. Participants were followed from study entry (1964, 1971 and 1976) until death or the end of the follow-up period (number of years not given). A total of 4,833 participants died. Of these, 1,075 died of coronary heart disease and 1,552 died of cancer.”

The conclusion was that drinker’s mortality if consumed in moderation  was far lower than non drinkers.

0 drinks/wk 1.00 (referent)

1–7 drinks/wk 0.82 (0.76–0.88)

8–21 drinks/wk 0.82 (0.75–0.89)

22–35 drinks/wk 1.00 (0.89–1.12)

35 drinks/wk 1.10 (0.95–1.26)

Beer and wine drinkers had reduced heart disease no matter how much they drank while spirit drinkers hovered around 1.0 null hypothesis. On cancer wine drinkers no matter how much they drank had reduced incidence of cancer while the heaviest beer and spirit drinkers had an increase in cancer.  Overall mortality was that wine drinkers lived longer than non drinkers, as did moderate beer drinkers with spirit drinkers only exceeding non drinkers at 21 units a week.

The final conclusion is that all alcohol drinkers between 1 to 21 units a week live longer than non drinkers at 22-35 units reach equilibrium with non drinkers and >35 units 1.10 (0.95-1.26) a slightly raised risk.

Update

Tony was kind enough to post this British Medical Journal

http://www.bmj.com/content/309/6959/911.full

“It shows that all cause mortality is lower for drinkers (of less than 43 units per week) than for non-drinkers. Even at >=43 units (mean 61.3) the mortality is only slightly higher than the teetotal group and remember that this includes some who would have consumed a couple of hundred per week.”

It me but one thing that I have noticed is that on passive smoking and alcohol studies if you go back to the 1980s, 90s many of the studies I review have a high propensity to support the null hypothesis but in the last 10 years or so more and more lifestyle papers tend to show risk. It maybe me, coincidence or am I  mistaken.

Me, I am off for a glass of merlot.

1. http://au.news.yahoo.com/latest/a/-/article/9289573/dont-drink-its-carcinogenic-report/

2. https://lh5.googleusercontent.com/-L4B_orDIiBI/TXZrlvw4HkI/AAAAAAAAAgY/D42I-8evsXw/s1600/heart+alcohol+plot.jpg

3. http://velvetgloveironfist.blogspot.com/2011/03/david-nutt-shows-his-true-colours.html

http://www.annals.org/content/117/8/646.short

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3 Responses to A review of alcohol consumption and mortality, bottoms up for me

  1. Dimi Kar says:

    Is it coincidence that at the same time pills against alcoholism appear in the market?

    But whilst smoking was an ‘easy target’ , things will be considerably much more difficult with drinking .And practically speaking ,what are they going to do ? Ban alcohol on Bars ? Ofcourse never say never after what happened with smoking…

  2. Tony says:

    Dave,

    You might find this study of interest too:
    http://www.bmj.com/content/309/6959/911.full

    You’ll recognise the cohort of course but take a look at table 1V. It shows that all cause mortality is lower for drinkers (of less than 43 units per week) than for non-drinkers. Even at >=43 units (mean 61.3) the mortality is only slightly higher than the teetotal group and remember that this includes some who would have consumed a couple of hundred per week.

    Also bear in mind that these are pre 2006 unit values i.e. larger than the ones that are used now.

  3. Junican says:

    Chaps! As I read the above, I found myself giggling. I was giggling because of the inherent contradictions between ‘drinkers live longer’ versus ‘alcohol causes cancer’. They can, of course, both be true, provided that non-drinkers die sooner for whatever reason. But the real hilarity is concerned with the fact that it is becoming clearer and clearer to anyone with any intelligence that epidemiology has more in common with religious edict than with science. I feel that I can say this because the base ‘experimental evidence’ in epidemiology is hearsay. I say ‘hearsay’ because the base info comes from ‘form filling’, which may or may not be true, depending upon the ‘feelings’ of the person filling in the form. But, what is worse, access to the forms is denied.

    It is odd how Tobacco Control rely upon the ‘multiplicity’ of studies, and yet, in almost every case, the majority of the studies in a metastudy are neutral.

    But, of course, Tobacco Control has the funding and the ear of Government. I fear that we must let the situation play itself out. Let it run, but continue to reveal the nonsense for what it is. Be patient. ‘Freedom TO’ will eventually overcome ‘Freedom FROM’.

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